| NPI | 1679523997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 87703) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-12318) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-06-11 |